Source · Select Committees · Health and Social Care Committee
Recommendation 36
36
Paragraph: 165
We are deeply concerned about the increasing numbers of children and young people who experience...
Conclusion
We are deeply concerned about the increasing numbers of children and young people who experience self-harm and suicide and the quality of care they are able to access. Much more needs to be done to tackle suicide and self-harm amongst children and young people. In particular, given the link between self-harm in children and young people and later suicidality, any suicide prevention strategy must include improving the support available to those who self-harm. We have heard that too often, children and young people’s mental health services are not commissioned with self-harm in mind. It is essential that self-harm is not used as a reason to reject referrals to mental health services. While we welcome the inclusion of self-harm in the National Suicide Prevention Strategy, we are clear that support must be available earlier to these children and young people, before they reach a crisis point.
Paragraph Reference:
165
Government Response
Not Addressed
HM Government
Not Addressed
We accept this recommendation in part. The Government is accelerating the role out of MHSTs. We agree that education settings can have an important role in prevention and early intervention. MHSTs, where established, are a key part of this. MHSTs are one of the core proposals of Transforming Children and Young People’s Mental Health Provision: a Green Paper. As detailed in our response to Recommendation 3, we committed to implement MHSTs to 20-25% of England by the end of 2022/23. We are now accelerating role out of MHSTs. In March 2021 we announced an additional £79million funding to support and expand children and young people’s mental health services, including MHSTs. We are on track to have MHSTs covering 25% of the country by 2022/23 – a year earlier than originally planned – and this will increase to around 400 teams, covering an estimated 3 million children and young people, by 2023/24. It is important when accelerating the roll-out of MHSTs, that we consider the workforce required to fill roles, and the training times needed for new posts such as education mental health practitioners. We have to balance ambitious targets with the finite resources of the NHS. Training for Education Mental Health Practitioners EMHPs are a key role within MHSTs. EMHPs undertake a Postgraduate/Graduate Diploma through which they are trained to deliver low intensity interventions with children, young people and their parents/carers, for common mental health problems such as anxiety, low mood and behavioural difficulties. Through the EMHP curriculum, EMHPs are already expected to gain competencies for specific interventions, including on recognising the symptoms and course of low mood and self-harm in children and young people. The curriculum also includes competencies around: working with parents of young people with low mood and/or self-harm to encourage parents to refrain from punishment or unhelpful advice giving in relation to low mood and/or self-harm; and to help parents distinguish between low mood and self-harm behaviours and other problematic behaviours. In addition to the commitments being delivered under the NHS LTP to improve support for children and young people experiencing a mental health crisis (see recommendation 18), NHSE/I plan to introduce a new Commissioning for Quality and Innovation (CQUIN) incentive in April 2022, focused on improving the quality of care for people who self-harm and attend A&E. This is expected to require psychiatric liaison teams to ensure that 80% of self-harm referrals receive a biopsychosocial assessment in line with NICE guidelines.